Safe, Effective Removal of Skull Base Tumors

11/17/2014

Pictured: SLUCare cross disciplinary team with neurology and otolaryngology

It was just a routine eye exam. But the peripheral vision loss her eye doctor detected
—too little for Stephanie Rose even to notice — concerned him enough to refer Rose
to the emergency room. The vision loss was misdiagnosed and treated as a pituitary
cyst, and Rose didn't find out until seven years later that what she actually had
was a pituitary adenoma, a benign tumor.

That's what brought her to the office of Dr. Jeroen Coppens, a SLUCare Physician Group neurosurgeon and assistant professor of neurosurgery at
Saint Louis University. Coppens partnered with Dr. Jastin Antisdel, chief of SLUCare Physician Group's division of rhinology, sinus and anterior skull
base surgery program, to perform a minimally invasive endoscopic procedure that involves
entering the skull base through the nose.

The goal of the surgery is to remove the tumor so it doesn't grow back, and if the
patient has had vision loss, we also make sure we take the tumor off the optic nerves
so people can regain optimal vision.”

"SLUCare's skull base program covers a wide range of pathologies, but we mainly deal
with pituitary tumors and other rare forms of anterior skull base tumors," Coppens
says. "The goal of the surgery is to remove the tumor so it doesn't grow back, and
if the patient has had vision loss, we also make sure we take the tumor off the optic
nerves so people can regain optimal vision."

A successful skull base surgery requires a team approach. "I make sure we preserve
as much of the nasal function as possible, and Dr. Coppens then removes the tumor,"
says Antisdel, who also is the director of the Saint Louis University Sinus Institute.
"As far as having endoscopically trained neurosurgeons working in conjunction with
trained rhinologists, SLUCare has more to offer than anyone else. We offer a high
level of integrated care, and we do a lot of these surgeries."

Removing tumors endoscopically with a scope less than half a centimeter in diameter
has major benefits for patients like Rose. "We used to have to split open the inside
of the nose or go underneath the lip," Antisdel says. This could cause significant
nasal issues, including numbness in the face and a loss of the sense of smell, he
adds. "With the endoscopic approach, we can check out our blind spots, look behind
the carotid artery and make sure we remove the entire tumor," Coppens says.

And a less invasive surgery means a shorter recuperation time. "Patients leave the
hospital on average two to five days after surgery," Antisdel says. "The sense of
smell returns to normal. With many of our patients, when they walk out of surgery
you would never know by looking at them, because it's all done on the inside."

Rose, whose procedure was successful, continues to see Dr. Coppens once a year for
follow-up MRIs. "He makes sure everything is good and stable," she says. "If the tumor
comes back, he most likely will be able to use radiation to treat it. I probably will
never need surgery again."